缺血性中风患者血管内介入治疗前后证候要素及Lp-PLA2水平的相关性研究

Correlation Study of Syndrome Elements and Lp-PLA2 Level Before and After Intravascular Intervention in Ischemic Stroke Patients

目的:探讨缺血性中风血管内介入治疗前后证候要素变化及其与脂蛋白相关磷脂酶A2(Lp-PLA2)水平。方法:选取2020年3月—2021年9月茂名市中医院收治的缺血性中风患者80例为观察对象,根据血管内介入治疗前后四诊信息进行证候要素诊断,比较治疗前后各证候要素情况及Lp-PLA2水平。结果:缺血性中风血管介入治疗前的证候要素,内风频次最高(76例),内火和阴虚频次最低(13例),痰湿、血瘀、气虚分别为35、37、29例;治疗后内风频次最高,达59例,阴虚最少(14例),内火、痰湿、血虚、气虚分别为15、38、46、26例。缺血性中风证候要素组合多变,治疗前后单一证候因素较少,两证和三证相兼占比较高。治疗后患者Lp-PLA2水平低于治疗前,差异有统计学意义(P<0.001)。治疗后,不同证候因素患者Lp-PLA2水平均较治疗前下降,差异有统计学意义(P<0.001);各证候因素Lp-PLA2水平治疗前、治疗后及治疗前后差值比较,差异无统计学意义(P>0.05)。结论:缺血性中风血管内介入治疗前后各证候要素的分布频率、证素组合均出现了一定变化。Lp-PLA2水平可能与缺血性中风的发病机制存在密切关系。

Objective:To investigate the changes of syndrome elements before and after intravascular intervention for ischemic stroke and their correlation with lipoprotein-associated phospholipase A2(Lp-PLA2)levels.Methods:A total of 80 patients with ischemic stroke who were admitted to Maoming Hospital of Traditional Chinese Medicine from March 2020 and September 2021 were selected as the observation subjects.The syndrome elements were diagnosed according to the information of four diagnostic methods before and after intravascular intervention.The syndrome elements and Lp-PLA2 levels were compared before and after treatment.Results:Among the syndrome elements of ischemic stroke before vascular interventional therapy,the frequency of internal wind was the highest(76 cases),the frequency of internal fire and Yin deficiency was the lowest(13 cases),and the phlegm dampness,blood stasis and qi deficiency were present in 35 cases,37 cases and 29 cases,respectively.After treatment,the frequency of internal wind was the highest(59 cases),and the frequency of Yin deficiency was the lowest(14 cases).The internal fire,phlegm dampness,blood deficiency and qi deficiency were present in 15 cases,38 cases,46 cases and 26 cases,respectively.The combination of syndrome elements of ischemic stroke was variable,and the number of single syndrome element before and after treatment was relatively low,and the combination of two syndromes and three syndromes accounts for a higher proportion.The level of Lp-PLA2 after treatment was lower than that before treatment,and the difference was statistically significant(P<0.001).Lp-PLA2 levels in patients of different syndrome elements were decreased after treatment compared with those before treatment,and the difference was statistically significant(P<0.001).There was no significant difference in Lp-PLA2 levels among different syndrome elements before and after treatment,as well as in the difference before and after treatment(P>0.05).Conclusion:The distribution frequency and combination of syndrome elements of ischemic stroke have certain changes before and after intravascular intervention.Lp-PLA2 levels may be closely related to the pathogenesis of ischemic stroke.